From the TUC

NHS privatisation battle continues

03 Apr 2013, by in Public services

The most sweeping changes to our NHS since its inception were put in place on Monday. But as the new system grinds into gear the fight continues, including an immediate battle over the competition regulations at the heart of the ‘reforms’. There’s a chance to defeat this core element of the Government’s plans in Parliament this month, and we’re asking supporters to contact MPs and members of the House of Lords to ensure that they act.

When the Procurement, Patient Choice and Competition Regulations under section 75 of the Health and Social Care Act were quietly published in February there was uproar from the public, medical professions and health unions. They all believed the regulations broke promises Ministers made during the passage of the Act that decisions about whether, when and how to use competition would lie squarely with the new GP commissioners. Instead they would force services out to competition. The outcry forced the Government to rewrite and a second version was laid in March, coming into effect on 1 April.

So what changed? Some warm words about integration and co-operation were added to the new regulations and some of the most explicit pro-competition wording was removed. But experts agree that the new wording has much the same effect as the previous version.

The key point is the ‘single provider test’ in regulation 5. To award a contract to provide health care services without a competition, commissioners will have to be satisfied that only that provider is capable of delivering that service.

There are lots of sensible reasons why commissioners might not want to put a service out to competition. For instance, they might think the contract is too small to justify the trouble and expense of a competition, or they might want to support a local NHS provider that is already delivering a good service for patients.

But if they can’t be certain there is only one possible provider, they will have to subject the service to competition. As this blog explains, there will often be more than one possible provider, for instance where a town has more than one hospital. Private and voluntary sector providers are likely to claim that they are potential providers too.

The bar is set so high that CCGs will end up feeling that the only way to ‘prove’ there is only one provider is to hold a competition. They are also likely to be nervous that they will face legal challenges from private providers who want to get into the NHS.

Not only will this increase the privatisation of the NHS, it will mean time and money wasted on complicated contracting processes. It will make money for lawyers and management consultants that could be better spent on providing care.

The medical professions are not convinced by the cosmetic changes. The BMA, RCN, RCGP and NHS Clinical Commissioners have all spoken out and 250 doctors have signed an open letter in the British Medical Journal.

Legal advice for 38 degrees by David Lock QC sets the risks out clearly.

A key Lords Committee examined the new regulations and their incisive report (see section C) was critical of the rushed, last-minute policy-making process and the confusion over what the revised regulations mean. The Committee sympathised with the view the regs should be revoked to allow more time for consultation, and have referred them for the ‘special attention’ of the House of Lords.

We’re asking people to contact peers and ask them to give the regulations the scrutiny they deserve by joining the debate on 24 April and supporting the ‘fatal motion’ laid by Labour’s health lead in the Lords, Phil Hunt. If enough Liberal Democrat and Crossbench peers can be persuaded to support it the motion will scrap the regulations and force the government to think again.

MPs have a part to play too. The equivalent procedure to ‘pray against’ the regs in the Commons is an Early Day Motion signed by the leader of the Opposition. Make sure your MP has signed EDM 1188 to secure a debate there too.

There will be much more to do to protect our NHS from the worst of these reforms over the coming years. But at this point a defeat for these dangerous regulations is vital.

8 Responses to NHS privatisation battle continues

  1. Patrick
    Apr 3rd 2013, 8:25 pm

    Are the Trade Union Leaders going to give us some leadership and get everyone onto the streets. We will probable get the same leadership that the MINERS GOT.

  2. ming Chien
    Apr 4th 2013, 1:52 pm

    Aneurin Bevan would be turning over in his grave!
    I dont see that in the modern world, where there are definite areas of weaknesses in society and poor and hungry people around, why the Government is so intent on making the great divide even greater. So, the people of the nation are just a hindrance now?

  3. Norman and/or Lorraine Hill
    Apr 5th 2013, 8:37 am

    Usually, leaders of trade unions only take a determined stand if the majority of the membership demands it of them. I don’t know how things are in other parts of the country but if they are the same as here in Furness (trade union members not interested in anything other than their own personal wages and working conditions) then TU leaders know any call for even a token one-day demonstration will fall on the deaf ears of the majority. (Yes, nationally, a few thousand might turn up for a banner-waving, horn-blowing fun day – but that is all) No TU leader can be willing to call for direct action without assurance of receiving the full support of the members for this. Currently, leaders do not have this assurance and that is the reason why nothing is happening.

  4. stephen Webb
    Apr 5th 2013, 10:33 am

    As an active Trade Unionist I can empathise with some of the above comments including Norman and Lorraine, however the Trade Unions are to all intent and purposes democratic institutions and have to follow the opinions of the majority. If the majority of the membership do not want to lose money and dont want to strike or take any form of action then there is nothing a Trade Union can do.
    However this is can be overcome if we had dynamic leadership at a local and national level and in some quarters at the moment we do not, that I agree with. In fact we mirror other political institutions and we have become elite and hierarchical but only the membership can change that not the activists. If you dont ilke your reps remove them through the democratic processes available to you under the constitutions of your unions.

  5. Norman and/or Lorraine Hill
    Apr 5th 2013, 11:31 am

    Stephen, you write “If you don’t like your reps remove them through the democratic processes available to you under the constitutions of your unions.”
    There can be no democratic processes if members cannot be bothered to attend the branch meeting (held once every two months) despite the incentive of a free meal and a drink!
    I (Norman) have been a consistently active trade unionist all my working life and continue to be so even though now retired. Throughout this time I have observed that members renewed their membership just as they would that of their vehicle breakdown service provider: they pay the fee, expect the service and have not the slightest desire to engage in any ‘democratic process’.

  6. Vanessa Rambridge
    Apr 5th 2013, 5:01 pm

    This Government of RICH MILLIONAIRES have no idea how the majority of the people live. THIS IS OUR NHS to which we have contributed in our taxes, built the hospitals. trained and equipped the staff, so hands off

  7. Theremustbeanotherway
    Apr 28th 2013, 8:24 pm

    The privatisation of the NHS is a travesty, just look at the US. The Tories and Nu Labour have already sown the seeds. Tories in particular have been borrowing from the GOP “dirty tricks manual”. One of these dirty tricks is to put a spanner in the works of any cost effective and well run state concern, so that it can be privatised, because “the market knows best”. Look at the way GOP are attacking Social Security in in the US.

    The costs of healthcare will then run away with the consumer footing the bill (see the US model of healthcare). The privatisation will also let Gideon off the hook and enable him to shrink the deficit. Watch all the “wealth creators” pile into the NHS, a bit like a shark feeding frenzy! It’ll be easy money for them!

    If you don’t believe me look at Education and how the cost at the tertiary level has been shifted to the consumer. Student loan anyone? Again look to the US for the problem this creates!